Botox for Hyperhidrosis - Didn't Work for Me 3 Times. Why?

I had my first injections about 2 yrs ago and they didn't work. I then had my second set about 5 months later and still it didn't work. I had my second set 3 days ago and I'm still sweating. I believe my first 2 injection i got a total of 24 injections and the last time I had a total of 40. What's going on? Why didn't it work? Also how I think I have a resistant bacteria under my arms because nothing gets rid of the odor and its over powering. Is there anything I can do for that?

Doctor Answers (19)

No Botox Options for Sweating

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If Botox doesn't work for you try miraDry. MiraDry is a clinically proven and safe FDA-approved solution for significantly reducing underarm sweat. It’s an outpatient procedure performed in your physician’s office. It is not surgery so doesn’t involve surgical incisions. miraDry delivers controlled electromagnetic energy to the arm pit, eliminating the underarm sweat (eccrine) glands.
Two procedures are typically recommended. Each occurs approximately three months apart for best results.

Other  surgical options involve superficial liposuction or excision of sweat gland skin poses additional risks and leave scars.


Orange County Plastic Surgeon
5.0 out of 5 stars 48 reviews

Botox failure for hyperhydrosis

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Three strikes and you are out.  Cellulaze Sidelaze will treat hyperhydrosis in one treatment with immediate results, mild swelling and discomfort.

Please consult in person with a Board Certified Plastic Surgeon prior to making any treatment decisions.

Luis A. Cenedese, MD, FACS
New York Plastic Surgeon
4.0 out of 5 stars 11 reviews

Botox does not treat bromhidrosis (excessive odor) - Botox Treats Hyperhidrosis

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If Botox has been ineffective, stop getting Botox injections. Assuming that you have had different doctors inject Botox, 3 injection sessions by 3 different practitioners suggests that it is not likely to work for you - even though this is unusual and not something that is observed by experienced hyperhidrosis experts.
Having said that, Botox does not treat bromhdrosis (excessive oder). Botox treats hyperhidrosis.
miraDry treats both hyperhidrosis AND bromhidrosis.
You can contact me via my website and I will send you a free copy of a book I have written about the miraDry procedure. See the link below.

Hratch Karamanoukian, MD, FACS
Buffalo General Surgeon
4.5 out of 5 stars 7 reviews

Try miraDry

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miraDry is the answer to excessive underarm sweating. Lasting results with only 2 treatments. It is a quick in-office procedure.

Michael L. Maris, MD
Dallas Dermatologic Surgeon
5.0 out of 5 stars 6 reviews

Why Botox for hyperhidrosis might not work: missing the target depth!

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The injection depth for hyperhidrosis is less than for cosmetic treatment of wrinkles on the face. On the face, the muscles of expression lie totally beneath the level of the skin, and under the arms, the Botox should be aimed at the tiny, tiny muscles that control the openings of sweat glands, which are actually inside the skin more superficially.

If you had the same doctor inject you all three times, it is possible this injector was injecting a little too deep and really missing the main target.

Jessica J. Krant, MD, MPH
New York Dermatologic Surgeon
4.5 out of 5 stars 40 reviews

Treatment of Hyperhidrosis

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If you have had a treatment failure, you likely did not have enough Botox injected.  You say that you had 40 units injected total.  To have a positive effect, you likely need at least 50 units injected per side for a total of 100 units.  

 

Good Luck.

David Shafer, MD
New York Plastic Surgeon
5.0 out of 5 stars 57 reviews

Botox for Hyperhidrosis - Didn't Work for Me 3 Times. Why?

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Regarding: "Botox for Hyperhidrosis - Didn't Work for Me 3 Times. Why?
I had my first injections about 2 yrs ago and they didn't work. I then had my second set about 5 months later and still it didn't work. I had my second set 3 days ago and I'm still sweating. I believe my first 2 injection i got a total of 24 injections and the last time I had a total of 40. What's going on? Why didn't it work? Also how I think I have a resistant bacteria under my arms because nothing gets rid of the odor and its over powering. Is there anything I can do for that
?"

I suspect you were treated by one of more of the following:

- inexperienced injector
- unethical injector
- old, inactive Botox
- overly diluted (inactive) Botox
- gray market or fake Botox.

Botox when used fresh, in sufficient strength by an experienced doctor should work on everyone.

I would suggest you consider switching to a Plastic surgeon or Dermatologist.

Dr. Peter Aldea

Peter A. Aldea, MD
Memphis Plastic Surgeon
5.0 out of 5 stars 63 reviews

Botox and hyperhydrosis

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Botox usually is an excellent treatment for hyperhydrosis.  Although you may have a resistance it is very unusual.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 17 reviews

Consider surgical options for axillary hyperhidrosis if Botulinum toxin (Dysport and Botox) doesn't work

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There are surgical options for hyperhiudrosis that invoive severing the sympathetic nerves thar stimulate the production of sweat.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 48 reviews

Botox for hyperhidrosis usually works very nicely

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Botox for hyperhidrosis usually works very nicely. It can take up to 2-3 weeks to get the final result. It takes longer for wrinkle correction. There are a rare group of people who have antibodies to BOTOX and for them BOTOX Cosmetic might not work. It’s more likely that the dose you have been getting is not high enough for hyperhidrosis. You usually need at least 60 units per side and can go up to 80. If raising the dosage does not work, you can also try Dysport or Xeomin. These other neuromodulators may work if you are resistant to BOTOX.

Joseph A. Eviatar, MD, FACS
New York Oculoplastic Surgeon
5.0 out of 5 stars 27 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.